Australian Critical Care最新文献

{"title":"Employer-provided wellbeing support for nurses working in intensive care units: A national cross-sectional study","authors":"Yuzi Zhou RN, MAdvN ,&nbsp;Pauline Wong RN, PhD ,&nbsp;Angelique Clarke RN, MN (critical care) ,&nbsp;Rebecca J. Jarden RN, PhD ,&nbsp;Wendy Pollock RN, PhD, RM, FACCCN","doi":"10.1016/j.aucc.2025.101200","DOIUrl":"10.1016/j.aucc.2025.101200","url":null,"abstract":"<div><h3>Background</h3><div>Intensive care units are characterised as high-stress work environments that may negatively affect nurses’ wellbeing. Employer-provided support has a crucial role in reducing burnout and improving wellbeing.</div></div><div><h3>Objective</h3><div>The aim of this study was to examine wellbeing supports routinely offered by employers of nurses working in intensive care units and examine the relationships amongst perceived organisational support, wellbeing, and burnout.</div></div><div><h3>Methods</h3><div>A cross-sectional study of nurses working in Australian intensive care units was conducted from 4 to 19 September 2023. A web-based survey was distributed via the Australian College of Critical Care Nurses and social media, with snowball sampling. Validated tools for perceived organisational support, subjective wellbeing, and burnout were used.</div></div><div><h3>Results</h3><div>Of 668 responses, 632 met inclusion criteria for analysis (94.6%). Education and training were the most common supports recognised by nurses (63.4%, <em>n</em> = 401). The most helpful support was childcare assistance (M = 3.17, standard deviation [SD] = 1.38). Higher levels of perceived organisational support were associated with better subjective wellbeing (<em>r</em> = 0.20; p &lt; 0.001). Perceived organisational support was higher for nurses without burnout (M = 4.15, SD = 0.89) than for those with burnout (M = 3.64, SD = 0.85; t [625] = 7.43, <em>p</em> &lt; 0.001, two-tailed). For every one-point increase in the mean value of perceived organisational support, nurses were 56% less likely to report experiencing burnout than those who perceived lower organisational support (B = −0.81, <em>p</em> &lt; 0.001, odds ratio = 0.44, 95% confidence interval: 0.35–0.56). The strongest predictor of reporting burnout was engaging in an education/clinical support job role (B = 0.88, <em>p</em> = 0.04, odds ratio = 2.41, 95% confidence interval: 1.04–5.60).</div></div><div><h3>Conclusions</h3><div>Nurses working in Australian intensive care units perceived employer-provided wellbeing support to be inadequate. Perceived organisational support is a modifiable independent predictor of burnout, suggesting that employers need to work with nurses to improve wellbeing supports.</div></div><div><h3>Registration</h3><div>Not registered.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101200"},"PeriodicalIF":2.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidepressant use, but not polypharmacy, is associated with worse outcomes after in-hospital cardiac arrest in older people","authors":"Gustavo Martins Ferreira BN ,&nbsp;João Carlos Clarck Barros BN ,&nbsp;Nayane Maria Vieira MN ,&nbsp;Isabelle de Almeida Souza BN ,&nbsp;Asiya Shalova BN ,&nbsp;Bertha Furlan Polegato MD, PhD ,&nbsp;Leonardo Antônio Mamede Zornoff MD, PhD ,&nbsp;Sergio Alberto Rupp de Paiva MD, PhD ,&nbsp;Paulo José Fortes Villas Boas MD, PhD ,&nbsp;Danilo Martins MD, PhD ,&nbsp;Edson Luiz Favero Junior MD, PhD ,&nbsp;Taline Lazzarin MD ,&nbsp;Jemima Collins MD, PhD ,&nbsp;Paula Schmidt Azevedo MD, PhD ,&nbsp;Marcos Ferreira Minicucci MD, PhD","doi":"10.1016/j.aucc.2025.101201","DOIUrl":"10.1016/j.aucc.2025.101201","url":null,"abstract":"<div><h3>Background</h3><div>It is already known that age and some chronic diseases are associated with worse outcomes after in-hospital cardiac arrest (IHCA). Usually, patients with two or more chronic diseases are treated with multiple medicines, which is commonly referred as polypharmacy (five or more medications). The objective of this study was to evaluate the association between polypharmacy and antidepressant use before hospital admission with return of spontaneous circulation (ROSC) and in-hospital mortality in IHCA.</div></div><div><h3>Methods</h3><div>This retrospective study included patients over 18 years of age with IHCA, attended by the rapid response team in hospital wards, from March 2018 to September 2023. The exclusion criteria were the absence of information regarding polypharmacy, pregnancy, and the presence of an express “do-not-resuscitate order”. Data were collected from the electronic medical records.</div></div><div><h3>Results</h3><div>A total of 578 patients with IHCA were evaluated; 42 patients were excluded due to the absence of information regarding polypharmacy and 24 due to “natural death permission”. Thus, we included 512 patients in the analysis. The mean age was 64.4 ± 14.9 years; 52.3% were male, and 54.5% were older people. Polypharmacy was prescribed for 50.8% of patients, 48.4% had ROSC, and in-hospital mortality was 92.0%. In logistic regression models, the polypharmacy regimen use in the older population was not associated with ROSC (odds ratio [OR]: 1.122; 95% confidence interval [CI]: 0.660–1.906; p: 0.672) or mortality (OR: 1.185; 95% CI: 0.170–8.260; p: 0.864). Regarding antidepressant use, it was associated with lower rates of ROSC (OR: 0.412; 95% CI: 0.183–0.925; p: 0.032) but was not associated with mortality in older people (OR: 1.682; 95% CI: 0.129–21.996; p: 0.692).</div></div><div><h3>Conclusions</h3><div>In conclusion, polypharmacy regimen was not associated with ROSC and in-hospital mortality; however, antidepressant use was associated with lower rates of ROSC only in older patients.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101201"},"PeriodicalIF":2.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding crisis needs among family caregivers of patients in critical care: A qualitative analysis","authors":"Amanda C. Blok RN, PhD ,&nbsp;Thomas S. Valley MD, MSc ,&nbsp;Lauren E. Gauntlett MPH ,&nbsp;Jacquelyn Miller MA ,&nbsp;Kyra Lipman BS ,&nbsp;Sarah L. Krein RN, PhD","doi":"10.1016/j.aucc.2024.101168","DOIUrl":"10.1016/j.aucc.2024.101168","url":null,"abstract":"<div><h3>Background</h3><div>Family caregivers often experience shock and disorientation when a patient is admitted to critical care. Developing interventions to assist caregivers during this crisis requires a more in-depth understanding of their needs.</div></div><div><h3>Objective</h3><div>Our aim was to understand family caregivers' needs during a patient's critical care admission and early hospitalisation and differences in needs by caregiver anxiety level.</div></div><div><h3>Methods</h3><div>We conducted a descriptive mixed-method study. Forty semistructured interviews were conducted with family caregivers of mechanically ventilated critical care patients. The Hospital Anxiety and Depression Scale was also administered. Crisis theory was used to guide this analysis. The data were analysed by content analysis and then stratified by anxiety level to examine differences across groups. Consolidated Criteria for Reporting Qualitative Research were followed.</div></div><div><h3>Setting</h3><div>Two intensive care units at a large, tertiary academic medical centre were a part of this study.</div></div><div><h3>Findings</h3><div>Caregivers at all anxiety levels described needs involving information and emotional processing, social support, and self-care, with differences across anxiety groups. Caregivers with anxiety and borderline anxiety expressed limited capacity to think past the current moment, whilst caregivers with low anxiety actively used information to consider next steps and prepare others. Emotional processing appeared more limited in the anxiety and borderline-anxiety groups. Whilst most caregivers reported receiving some degree of social support, some caregivers with anxiety noted family tension, whilst caregivers with borderline and low anxiety had a wider variety of supportive relationships. Caregivers with anxiety reported distress influenced their self-care, whilst caregivers with borderline and low anxiety received tangible help from other family members for self-care.</div></div><div><h3>Conclusion</h3><div>Family caregivers of critical care patients experience needs during early hospitalisation, although the specific needs differ by caregiver anxiety level.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101168"},"PeriodicalIF":2.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Because I couldn't understand and respond”: A mixed-method study examining the impact of language barriers on patient experiences of intensive care unit outreach team care","authors":"Cheryl Power RN, MN Adv Prac ,&nbsp;Kylie O’Neill RN, MN ,&nbsp;Shu-Kay Ng BSc, PhD ,&nbsp;Edward Berry BN, Grad. Cert. Intens Care Nurs., RN ,&nbsp;Matthew Grigg BSc, MBBS(Hons1), FCICM, FRACP ,&nbsp;Gerald (Ged) Williams RN, MHA, LLM, FAAN, FACCCN ,&nbsp;Adelene Luong BMedSc ,&nbsp;Melissa J. Bloomer RN, PhD, FACCCN","doi":"10.1016/j.aucc.2025.101198","DOIUrl":"10.1016/j.aucc.2025.101198","url":null,"abstract":"<div><h3>Background</h3><div>Almost 10% of hospitalised patients experience acute deterioration requiring emergency intervention. Language barriers can impede patient assessment and health outcomes.</div></div><div><h3>Objective</h3><div>The objective of this study was to explore the experiences of adult inpatients whose preferred language was not English, who received care from the intensive care unit (ICU) outreach team.</div></div><div><h3>Methods</h3><div>An explanatory sequential two-phase mixed-method design was used. A retrospective audit was undertaken to explore characteristics of and outcomes for recipients of ICU outreach team care, according to preferred language. In phase two, interpreter-mediated interviews were conducted with former patients whose preferred language was not English to explore their experience of critical illness and care by the ICU outreach team.</div></div><div><h3>Results</h3><div>From 4234 inpatients who received care from the ICU outreach team in 2022, there was a mean of 3.54 episodes of care (1–565) per patient. Those whose preferred language was not English had a higher proportion of admissions from the emergency department and were more likely to have a medical emergency team call as their first outreach episode of care but less likely to be admitted to the ICU. Vietnamese and Mandarin were the next most common languages spoken after English. Twenty-two former patients or delegated relatives were interviewed. Not all recalled receiving care from the ICU outreach team. There was strong support for involvement of professional interpreters for critical conversations and to aid autonomy. Family members acted as lay interpreters and fulfilled familial and cultural obligations, but visitor restrictions impeded this.</div></div><div><h3>Conclusion</h3><div>Patient deterioration requires an emergent response. This research demonstrates the importance of identifying and overcoming language barriers for patients in a way that protects and preserves patient autonomy and ensures information accuracy. Where time and the patient's condition allows, use of professional interpreters must become the norm.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101198"},"PeriodicalIF":2.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of a three-dimensional printed model for training novice healthcare professionals in central venous catheter insertion: A cross-sectional study in a critical care setting","authors":"Felicity Edwards APD, BHlthSc ,&nbsp;Tara McCurdie PhD ,&nbsp;Dougal Carlisle MBBS FCICM ,&nbsp;George Pang MBBS FCICM ,&nbsp;Fiona Coyer RN, PhD ,&nbsp;Kevin B. Laupland MD, PhD, FCICM","doi":"10.1016/j.aucc.2025.101197","DOIUrl":"10.1016/j.aucc.2025.101197","url":null,"abstract":"<div><h3>Background</h3><div>We have previously used three-dimensional printing to develop a novel manikin for simulation training of central venous catheter insertion in critical care. The objective of this study was to evaluate the fidelity of the model by testing with novice and experienced operators.</div></div><div><h3>Methods</h3><div>A convenience sample of intensivist physicians experienced in central venous catheter insertion and critical care nurses without prior central venous catheter training was assembled. Participants were offered a video educational clip and a one-on-one demonstration. All participants were then asked to insert a central venous catheter into the model. Outcomes included requests for assistance, success rate, time to insertion, and subjective feedback.</div></div><div><h3>Results</h3><div>Thirteen intensivists and 14 nurses participated. Nurses were more likely to view the demonstration video prior to the procedure (13/14; 92.9% vs. 7/13; 53.9%; <em>p</em> = 0.033). Intensivists were more likely male (11/13; 84.6% vs. 3/14; 21.4%; <em>p</em> = 0.002) and tended to be older, with a higher proportion in the 35- to 44-year and 45- to 54-year age ranges than the nurses (92.3% vs. 71.4%; <em>p</em> = 0.426). Nurses requested more assistance and received more guidance but had similar overall success (100.0% vs 92.3%; <em>p</em> = 0.481). The median time taken for the procedure was 19 min and 59 s for nurses and 8 min and 14 s for intensivists (<em>p</em> = 0.004). All participants agreed that the model effectively prepared trainees for their first human central venous catheter insertion. Nurses also reported a significant increase in procedural confidence post simulation. Additionally, most participants agreed or strongly agreed that the model realistically simulated the femoral vein, an essential aspect of the central venous catheter insertion.</div></div><div><h3>Conclusions</h3><div>Nurses required additional assistance and took longer to complete the insertion, demonstrating preliminary evidence for the model's construct validity. Furthermore, the model was deemed a realistic training tool with successful insertion by nearly all participants.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101197"},"PeriodicalIF":2.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143277379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective review of the characteristics of patients deemed unsuitable for organ donation in a paediatric intensive care unit over a 5-year period","authors":"Mellissa Short MN ,&nbsp;Fiona Newall PhD ,&nbsp;Kate Masterson PhD","doi":"10.1016/j.aucc.2024.101161","DOIUrl":"10.1016/j.aucc.2024.101161","url":null,"abstract":"<div><h3>Introduction</h3><div>Children on organ transplant lists are more likely than adult patients to develop complications or die whilst waiting for a transplant. This reflects children's frequent need for size-matched organs, which are rarely available.</div></div><div><h3>Objectives</h3><div>The aim of this study was to review characteristics of patients deemed unsuitable for organ donation in a paediatric intensive care unit over a 5-year period to identify opportunities for practice improvement.</div></div><div><h3>Methods</h3><div>This was a quantitative, retrospective, observational study, using a descriptive design. Data were extracted from the clinical intensive care database STATIC into Microsoft Excel for children who died between the 1st of January 2018 and the 31st of December 2022. Data were analysed descriptively.</div></div><div><h3>Results</h3><div>Across the 5 years, 226 children died; 94 (41%) were referred to the state organ donation service DonateLife, and 26 (11.5%) became organ donors. Most children died from a cardiac cause. Of the total children who died, 152 (66%) were deemed to be unsuitable for organ donation. The most common reasons for children being deemed unsuitable for organ donation were as follows: poor organ function (46%), pre-existing systemic disease (34%), sepsis (15%), too young (10.5%), and due to legislation (9.8%).</div></div><div><h3>Conclusion</h3><div>This study identified cohorts of patients who were deemed unsuitable for organ donation. Based on published evidence, some of these patients may have been suitable or could have been considered for organ donation. Identifying these cohorts may optimise knowledge translation regarding donor suitability, with the outcome of increasing organ donation opportunities.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101161"},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of healthcare providers about the feasibility and implementation of early mobilisation of patients in critical care units in a Lebanese hospital","authors":"Noura Jannoun MSN, RN ,&nbsp;Samar Noureddine PhD, RN, FAHA, FAAN ,&nbsp;Houry Puzantian PhD, RN, FAHA ,&nbsp;Salah Zeineldine MD, FACP","doi":"10.1016/j.aucc.2024.101169","DOIUrl":"10.1016/j.aucc.2024.101169","url":null,"abstract":"<div><h3>Background</h3><div>Many survivors of critical care experience complications from bed rest after recovering from the acute phase. Early mobilisation helps patients recover faster. However, anecdotal evidence suggests that patients in critical care units are rarely mobilised.</div></div><div><h3>Aim</h3><div>The aims of the study were to assess the feasibility of early mobilisation of patients in intensive care units from the clinicians' perspective in a Lebanese hospital during the COVID-19 pandemic, identify associated institutional factors, and describe the knowledge, attitude, practices, and perceived barriers to early mobilisation among Lebanese clinicians.</div></div><div><h3>Methods</h3><div>A descriptive correlational design was used. Forty-nine healthcare providers (response rate: 41%) who work in critical care at a tertiary medical centre in Lebanon were recruited. Data were collected online via LimeSurvey using the Modified Mobility Survey Questionnaire. Descriptive statistics, bivariate correlations, and hierarchical multiple linear regression were used.</div></div><div><h3>Results</h3><div>Most respondents were nurses, and also included two physicians, four physiotherapists, and four respiratory therapists. Most respondents (67%) perceived early mobility to be crucial or very important, but only 33% thought its implementation was feasible. Many patient, provider, and institutional barriers to implementation were identified. Most clinicians thought that mobility must be started early, but 60% reported lack of training in mobilisation and identified patient instability, safety concerns, and lack of guidelines as barriers. Lack of equipment (unstandardised regression coefficient B = −0.87, 95% confidence interval = −1.7, −0.05; p = 0.039) and lack of guidelines (B = −0.67, 95% confidence interval = −1.37, 0.04; p = 0.063) were associated with lower feasibility of implementing early mobility in the multivariable analysis.</div></div><div><h3>Conclusion</h3><div>Despite appreciating benefits of early mobility, the respondents identified many barriers to its implementation. The findings suggest the need for staff education and training in early mobility and development of a multidisciplinary protocol on mobilisation. In addition, the needed human and physical resources ought to be assessed.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101169"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of a physiotherapy-led intensive prone positioning service in intensive care: A qualitative study with multidisciplinary clinicians","authors":"Stacey Haughton BExSci, DPT ,&nbsp;Krisha Saravanan BHSc, BPsychHons ,&nbsp;Luke A. McDonald BHlthSci, MPhysioPrac ,&nbsp;Joleen W. Rose BSci(Hons), BPhysio(Hons) ,&nbsp;Sue Berney BPT, PhD ,&nbsp;David J. Berlowitz BAppSciPhty, PhD ,&nbsp;Thomas C. Rollinson BPhysio(Hons) ,&nbsp;Marnie Graco BPhysio(Hons), PhD","doi":"10.1016/j.aucc.2024.101162","DOIUrl":"10.1016/j.aucc.2024.101162","url":null,"abstract":"<div><h3>Background</h3><div>The coronavirus disease 2019 (COVID-19) pandemic resulted in an increased number of patients with COVID-19–related respiratory failure requiring prone positioning. To reduce pressure on nursing and medical staff in the intensive care unit (ICU), a physiotherapy-led intensive prone positioning (PhLIP) service was implemented.</div></div><div><h3>Objectives</h3><div>The aim of this study was to explore the acceptability of the PhLIP service from the perspective of nurses and doctors working in the ICU and the physiotherapists who delivered the service.</div></div><div><h3>Methods</h3><div>A qualitative evaluation was conducted using semistructured interviews and focus groups, guided by the theoretical framework of acceptability (TFA). Participants included doctors, nurses, and physiotherapists who interacted with or delivered the PhLIP service.</div></div><div><h3>Results</h3><div>A total of 19 interviews (eight doctors and 11 physiotherapists) and four focus groups (13 nurses) were conducted. Eleven themes were identified within the eight domains of the TFA. Overall, the PhLIP team was highly valued and appreciated (TFA: affective attitude); enabled high-quality care and improved ICU efficiency (TFA: perceived effectiveness); reduced risks to patients and staff (TFA: perceived safety and risk); and was empowering for the clinicians involved (TFA: self-efficacy). Being in the PhLIP team was physically and mentally exhausting, and the service put strain on the physiotherapy department due to reallocation of staff (TFA: burden). Having trust in the physiotherapists leading the prone positioning service was a key influence on nursing and medical acceptance of the service.</div></div><div><h3>Conclusion</h3><div>The PhLIP team delivered an acceptable service that improved clinical care and efficiency during the COVID-19 pandemic. Other ICUs should consider the availability, skills, and confidence in the team selected to implement an intensive prone positioning service, should the need arise again. Researchers using the TFA to explore acceptability of healthcare innovations should also consider the recipients’ trust in those delivering the intervention.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101162"},"PeriodicalIF":2.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of net ultrafiltration intensity and clinical outcomes among critically ill patients receiving continuous renal replacement therapy: A systematic review, meta-analysis, and trial sequential analysis","authors":"Lu Jin MBBS,&nbsp;Peiyun Li MM,&nbsp;Qing Xu MBBS,&nbsp;Fang Wang MD,&nbsp;Ling Zhang MD, PhD","doi":"10.1016/j.aucc.2024.101170","DOIUrl":"10.1016/j.aucc.2024.101170","url":null,"abstract":"<div><h3>Background</h3><div>Net ultrafiltration (UF^net) has been used in the fluid management of critically ill patients undergoing continuous renal replacement therapy for an extended duration. Despite its widespread application, the correlation between UF^net intensity and clinical outcomes remains controversial.</div></div><div><h3>Methods</h3><div>Electronic databases (PubMed, Embase, Web of Science, and the Cochrane database) were searched from inception to November 30, 2023. All possible studies that examined the following outcomes were included: all-cause mortality, recovery of kidney function, and length of hospital stay.</div></div><div><h3>Results</h3><div>A total of 6209 patients from six cohort studies were included. There was no significant association observed between UF^net intensity and either mortality (odds ratio [OR] = 0.90, 95% confidence interval [CI] = 0.68–1.21, p = 0.49, I² = 84%) or renal recovery (OR = 0.96, 95% CI = 0.57–1.61, p = 0.87, I² = 75%) among critically ill patients. However, a high intensity of UF^net was associated with lower mortality in patients with acute kidney injury (AKI) (OR = 0.73, 95% CI = 0.59–0.90, p = 0.004, I² = 67%). Furthermore, the study revealed a noteworthy correlation between a high UF^net intensity and a longer length of hospital stay (weighted mean difference = 3.34 d, 95% CI = 2.64–4.03, p² = 0%).</div></div><div><h3>Conclusions</h3><div>The association between UF^net intensity and mortality or renal recovery in critically ill patients is insufficient. However, a high UF^net intensity is associated with an increasing length of hospital stay among critically ill patients.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101170"},"PeriodicalIF":2.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airborne personal protective equipment availability and preparedness in Australian and New Zealand intensive care units: A point prevalence survey","authors":"Adrian Regli FCICM, PhD ,&nbsp;Edward Litton FCICM, PhD ,&nbsp;Annemarie Palermo RN ,&nbsp;Naomi Hammond RN, PhD ,&nbsp;Serena Knowles RN, PhD ,&nbsp;Britta Sylvia von Ungern-Sternberg FANZCA, PhD ,&nbsp;the Point Prevalence Program Management Committee, The Australian and New Zealand Intensive Care Society Clinical Trials Group and The George Institute for Global Health","doi":"10.1016/j.aucc.2024.101163","DOIUrl":"10.1016/j.aucc.2024.101163","url":null,"abstract":"<div><h3>Background</h3><div>Personal protective equipment is essential to protect healthcare workers when exposed to aerosol-generating procedures in patients with airborne respiratory pathogens.</div></div><div><h3>Aim</h3><div>This study aimed to provide information regarding the level of airborne protection offered to nursing staff and other healthcare workers in Australian and New Zealand intensive care units (ICUs) 1 year into the coronavirus disease 2019 pandemic.</div></div><div><h3>Methods</h3><div>In this cross-sectional survey, ICUs in Australia and New Zealand were asked to participate in the Australian and New Zealand Intensive Care Society Clinical Trials Group Point Prevalence Program in June 2021. Sites were asked to contribute to questions regarding airborne protection offered to nursing staff and other healthcare workers.</div></div><div><h3>Results</h3><div>There were 51 participating sites. Negative-pressure bed space availability within participating ICUs included 24 with more than two, 15 with two, eight with one, and one ICU that did not have any. The median (interquartile range) number of different models and sizes of N95/P2 masks available to ICU staff was 6 (4–7). Of the 1018 nursing staff working that day in the units, 799 (78.5%) had at least one fit-tested N95/P2 mask in the correct size available. A total of 712 patients (461 medical and 251 surgical) were cared for by 700 bedside nurses in these ICUs. Overall, adequate airborne protection preparedness (airborne personal protective equipment training and fit-testing since the pandemic) was present in 548 (78.3%) bedside nurses.</div></div><div><h3>Conclusions</h3><div>Over a year into the coronavirus disease 2019 pandemic, airborne protection provided to nursing and other healthcare staff in Australia and New Zealand was often inadequate<strong>.</strong></div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101163"},"PeriodicalIF":2.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}